Gordon S B, Curran A D, Turley A, Wong C H, Rahman S N, Wiley K, Morice A H
Department of Medicine and Pharmacology, University of Sheffield, Royal Hallamshire Hospital, United Kingdom.
Am J Respir Crit Care Med. 1997 Jul;156(1):206-10. doi: 10.1164/ajrccm.156.1.9610042.
Workers exposed to irritant fumes experience symptoms both during the acute episode and afterwards. High-dose irritant exposure can result in permanent asthma, but the effects of chronic low-dose irritant exposure are not known. Glass bottle workers are exposed to irritant fumes, and have previously been reported to have an excess of symptoms. We designed a study to compare irritant-exposed glass bottle workers with hospital workers matched for socioeconomic group, area of residence, age, sex, smoking habit, and allergic history. Symptoms reported, spirometry, flow cytometric indices of lymphocyte activation, and past medical and employment histories were compared. We also investigated the prevalence of bronchial hyperresponsiveness to inhaled methacholine and the cough response after inhalation of citric acid and capsaicin. Glass bottle workers showed an excess of upper respiratory tract symptoms, cough, and shortness of breath compared with matched hospital control workers. There was a significant excess of cough induced by citric acid and capsaicin in the bottle workers. However, wheeze, baseline spirometry, flow cytometry, and methacholine challenge were not significantly different between the two groups. These findings suggest that chronic irritant exposure produces an excess of symptoms and increased cough sensitivity but not asthma.
接触刺激性烟雾的工人在急性发作期间及之后都会出现症状。高剂量接触刺激性物质可导致永久性哮喘，但慢性低剂量接触刺激性物质的影响尚不清楚。玻璃瓶工人接触刺激性烟雾，此前有报告称他们有过多的症状。我们设计了一项研究，将接触刺激性物质的玻璃瓶工人与在社会经济群体、居住地区、年龄、性别、吸烟习惯和过敏史方面相匹配的医院工作人员进行比较。比较了报告的症状、肺功能测定、淋巴细胞活化的流式细胞术指标以及既往病史和职业史。我们还调查了对吸入乙酰甲胆碱的支气管高反应性患病率以及吸入柠檬酸和辣椒素后的咳嗽反应。与匹配的医院对照工人相比，玻璃瓶工人出现过多的上呼吸道症状、咳嗽和呼吸急促。玻璃瓶工人中由柠檬酸和辣椒素引起的咳嗽明显过多。然而，两组之间的喘息、基线肺功能测定、流式细胞术和乙酰甲胆碱激发试验没有显著差异。这些发现表明，慢性接触刺激性物质会导致过多的症状和咳嗽敏感性增加，但不会导致哮喘。
